Tag: PSA

Day 2,457 – PSA Test Time

On By DanIn Prostate Cancer9 Comments

Yet another four months have elapsed, and Count Dracula just sucked another vial of blood out of my arm for my latest PSA test. (I shouldn’t disparage the good Count. He’s drawn my blood a couple of times now, and he’s truly the best phlebotomist who’s had the pleasure of poking holes in me.)

Now we let the waiting begin.

Historically, I can get my results online three days after the sample was taken, so we’ll see if that trend continues. (Interestingly, the VA appears to do one data upload a day around midnight Eastern time, so I may know something by late Saturday evening Pacific time.)

Speaking of trends, the nerd in me slapped a trend line onto my PSA tracker chart to see if it can be predictive of where my PSA will land this time around. Of course, in the world of prostate cancer, a Ouija board or a Magic 8-ball can be just as predictive—or more predictive—as my silly trend line.

The trend line prediction: Just slightly above the 0.09 ng/ml mark, indicating a continued increase. If I extrapolate from the last two data points alone, that predicts a PSA of 0.10 ng/ml. Of course, given the yo-yo trend of previous tests, I’m past due for another downward turn. Wagers, anyone???

One final footnote to all of this (biology ahead): To make sure that we have as accurate a reading as possible, I refrained from having an orgasm for a week in advance of the test.

Stay tuned.

PSA with Trend 20170802

Month 80 – PSA Threshold for Salvage Therapy Survey

On By DanIn Prostate Cancer, Recurrence29 Comments

Okay, please indulge my personal curiosity. This is going to be an interactive post—there’s a pop quiz for some readers.

I’m 22 days and 8 or so hours—give or take—from my next PSA test. (But who’s counting??) And anyone who’s been diagnosed with prostate cancer already knows that there’s a ton of infuriatingly conflicting and confusing information about PSA out there.

Because my own post-surgery PSA has been creeping up in the last two years—meaning some sort of salvage therapy may be in my future—I’d like to ask other prostatectomy patients:

  1. Below what PSA level does your medical team say PSA is “undetectable”?
  2. At what PSA level does your medical team say that biochemical recurrence has occurred?
  3. If you had biochemical recurrence, how long after hitting biochemical recurrence was it before you began salvage therapy?

To make it easier for you to respond, I’ve created a short survey for those who have had a prostatectomy and had their PSA return after surgery. It’s certainly not a scientific survey, but it will be interesting and perhaps educational to see the variance in the responses. If nothing else, it will be entertaining. Click the link below to take the survey:

PSA Threshold for Salvage Therapy Survey

Seriously, having this information available when I get my next PSA results may help me with the next conversation that I have with my medical team, so I thank you in advance for helping me understand what may be next for me.

I’ll share the results in next month’s post which will be shortly after I receive my PSA results from my 2 August 2017 blood draw.

I’ve been blogging for the last 80 months to maintain my own sanity, educate myself and others, and to increase prostate cancer awareness. I certainly don’t do it for recognition. I have to admit, however, that I was surprised to see my blog listed on a Top 50 Prostate Cancer blogs list by Feedspot.

I don’t post this to feed my ego (much), but by clicking on the image below, you’ll see the other websites and resources that are available as well.

Month 78 – Discussion with the Doctor

On By DanIn Prostate Cancer1 Comment

Another monthly post a few days ahead of schedule…

One thing about getting care through the Veterans Administration (VA)—I may see the same doctor only twice before a new one takes over my case. I think they’re on a six-month rotation and I’m on an four-month test cycle. Sometimes, I find the constant change in physicians annoying; other times, I like the idea of a second, third, or fourth opinion for differing perspectives.

This afternoon, I met with Doogie Howser, M.D. to review my PSA results from April. (Okay. He wasn’t actually Doogie. He’s a resident from University of California San Diego and didn’t appear to be much older than Doogie.) He was quite sharp and familiar with some of the more recent research and studies that have been done.

The meeting went pretty much exactly as I expected it to go:

  1. No real explanation for the yo-yo PSA readings.
  2. No need to panic yet; we’re not approaching the 0.2 ng/ml recurrence threshold.
  3. Slight concern about the last two consecutive readings increasing.
  4. Keep retesting on a four-month cycle.

And that was that.

I’ll go for my next blood draw in August with the follow-up appointment with Doogie (or his replacement) in September.

You may have noticed that I now have links to my Facebook and Google+ pages in the sidebar and footer in an ongoing effort to continue to raise awareness by sharing my story with a broader audience.

Month 77–The Results

On By DanIn Prostate Cancer1 Comment

The results are in. My latest PSA is 0.08 ng/ml, up from 0.06 ng/ml in December. That’s exactly where the trendline on my geeky spreadsheet graph told me it would be, so I’m not entirely surprised. Not pleased, but not surprised.

What does all of this mean? Who knows. On the good news side, I’m still well below the historically accepted 0.2 ng/ml cancer recurrence threshold. But I’m at the point now where I can no longer convince myself that these elevated PSA readings were just a byproduct of the change in PSA test methodology in March 2015. I’m sensing that something real is afoot here, and it doesn’t bode well.

My appointment with the doctor isn’t until 9 May 2017, so I’ll have plenty of time to think about this in advance and have a battery of questions ready for him. We’ll see if we’ll stick to the four-month test cycle or if he wants to increase the frequency. If we stick to the four-month cycle, my trendline would predict the next PSA to be between 0.09 and 0.1 ng/ml.

The last time we met, the doctor wasn’t willing to act until we got closer to the 0.2 ng/ml threshold. I’ll see if this result changes his opinion or if he’s been more accepting of some of the more recent research on prostate cancer recurrence. (You may recall from some of my earlier posts that several studies using the new ultra-sensitive PSA test showed that crossing the 0.03 ng/ml threshold was predictive of cancer recurrence and that intervention with salvage therapies sooner rather than later was more effective.)

I’m not going to pretend that this isn’t troublesome for me, because it is. But I also know that it’s still too early to go into full panic mode. If we stick to the four-month test schedule and August’s results come in at 0.07 or above, that will be one more data point to reinforce the notion that the cancer is, in fact, on its way back. At least in my mind. If it comes in less than that, I’ll be both happy and frustrated because of the continued uncertainty as to what’s really happening.

The journey—with its sometimes insufferable waiting—continues.

 

Day 2,339–PSA Test Time

On By DanIn Prostate Cancer2 Comments

It’s that time again. Another four months have elapsed and I just had my blood drawn for the next lap on the PSA roller coaster.

Actually, the anxiety leading into this test has been pretty much non-existent. Not that there isn’t any concern; it’s just that I haven’t let it control me. Why get all worked up about something you don’t know the answer to, right?

I should have my results by my next monthly update on 11 April. Stay tuned.

Month 76 – Status Quo

On By DanIn Prostate CancerLeave a comment

The last month has been a pretty busy month with relatives visiting from out of town and giving them the grand tour of San Diego County. There were also some transitions at work that have left us short-handed until we find a replacement for an employee who moved on to pursue his career elsewhere. Translation: Little time to think about pesky cancer.

But it’s approaching the four-month mark for my next PSA test, so those thoughts will be creeping to the front of my brain soon enough. I’ve scheduled my next PSA blood draw for 6 April 2017.

Till next month (with the latest PSA results in hand, hopefully)…

 

This Test Can Tell If Your Prostate Cancer Will Come Back

On By DanIn Prostate Cancer, ResearchLeave a comment

I came across this interesting article late tonight talking about how, if your post-treatment PSA nadir after RT or ADT is greater than 0.5 ng/ml, you’re more likely to have the prostate cancer return.

I’m going to re-read this with a fresh set of eyes tomorrow to better understand the study and its details.

http://nbcnews.to/2jIKECd

Day 2,241–Doctor’s Visit

On By DanIn Prostate Cancer7 Comments

My visit to the doctor this afternoon to review my latest PSA results (0.06 ng/ml) went just as I expected it would:

  1. There’s no definitive explanation for the elevated PSA yet.
  2. The elevated PSA seems to be stable, so no need to panic about recurrence.
  3. Retesting in four-month cycles will continue for the foreseeable future.

I’m okay with all of that. I seem to have turned the corner where I’ll always be concerned about my PSA, but I’m not going to let it control my life. It’s too consuming.

He reminded me of how slowly PSA can change and that we shouldn’t even begin to think about any intervention unless the PSA starts creeping up into the 0.15–0.18 range. That’s fine by me. If we get to that point, I’m going to be much more deliberate in selecting what, if any, salvage therapy would be appropriate given where I’m at in life and the potentially debilitating side effects that impact quality of life.

So I’ll call that visit a positive end to 2016. Let’s hope for a happy, healthy 2017!

Blasting Prostate Cancer with Testosterone

On By DanIn Research4 Comments

Here’s an interesting development in the field of prostate cancer research. The headline is a bit sensationalistic, but the researchers seem to be seeing “unexpected” and “exciting” results.

Professor Sam Denmeade, from Johns Hopkins University School of Medicine in Baltimore, US, who led the study, said: “”Our goal is to shock the cancer cells by exposing them rapidly to very high followed by very low levels of testosterone in the blood. The results are unexpected and exciting.

Man ‘cured’ of prostate cancer after doctors shock tumour to death with testosterone 

Update: 3 December 2016

Here’s the link to the abstract highlighting the preliminary results:

Rapid cycling high dose testosterone (Bipolar Androgen Therapy) as therapy for men with metastatic castrate-resistant prostate cancer (mCRPC)